Deans' stroke musings: Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, December 18, 2019

Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

So you fuckingly lazily described a problem, but offered NO SOLUTION. Good to know we can expect nothing from our stroke researchers.

Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

Ulrike Hammerbeck 1 , Matthew Gittins 2, Andy Vail 2, Lizz Paley 3 , Sarah F Tyson 4 and Audrey Bowen 1,* on behalf of the SSNAPIEST Team 1 Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK; ulrike.hammerbeck@manchester.ac.uk 2 Centre for Biostatistics, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Manchester M13 9PL, UK; Matthew.Gittins@manchester.ac.uk (M.G.); Andy.Vail@manchester.ac.uk (A.V.) 3 School of Population Health and Environmental Sciences, Kings College London, London SE1 1UL, UK; Lizz.Paley@phe.gov.uk 4 Division of Nursing, Midwifery and Social Work, University of Manchester, MAHSC, Manchester M13 9PL, UK; sarah.tyson@manchester.ac.uk * Correspondence: audrey.bowen@manchester.ac.uk; Tel.:+44-161-275-1235
Received: 30 October 2019; Accepted: 11 December 2019; Published: 13 December 2019

Abstract:

We established spatial neglect prevalence, disease proﬁle and amount of therapy that inpatient stroke survivors received, and outcomes at discharge using Sentinel Stroke National Audit Programme (SSNAP) data. We used data from 88,664 National Health Service (NHS) admissions in England, Wales and Northern Ireland (July 2013–July 2015), for stroke survivors still in hospital after 3 days with a completed baseline neglect National Institute for Health Stroke Scale (NIHSS) score. Thirty percent had neglect (NIHSS item 11≥1) and they were slightly older (78 years) than those without neglect (75 years). Neglect was observed more commonly in women (33 vs. 27%) and in individuals with a premorbid dependency (37 vs. 28%). Survivors of mild stroke were far less likely to present with neglect than those with severe stroke (4% vs. 84%). Those with neglect had a greatly increased length of stay (27 vs. 10 days). They received a comparable amount of average daily occupational and physiotherapy during their longer inpatient stay but on discharge a greater percentage of individuals with neglect were dependent on the modiﬁed Rankin scale (76 vs. 57%). Spatial neglect is common and associated with worse clinical outcomes. These results add to our understanding of neglect to inform clinical guidelines, service provision and priorities for future research.